Continuous subcutaneous hydrocortisone infusion for Addison's disease

Continuous subcutaneous hydrocortisone infusion attempts to replicate your body’s natural rhythm of hormone release. It can help people who are struggling to control their Addison’s disease or adrenal insufficiency especially in those with repeated Addison’s crises, and people who feel that their symptoms are affecting their quality of life.

The London Clinic’s expert endocrinologists will carefully assess your health and the way your Addison’s disease or adrenal insufficiency affecting your wellbeing.

The team will arrange all necessary investigations so that they can tailor a treatment plan to help you control your condition.

A hydrocortisone pump is a battery-powered device that delivers small amounts of medication into your subcutaneous tissue twenty-four hours a day. It’s attached to the body by a cannula, a fine tube that’s inserted under the skin. The pump is light and unobtrusive, it can be popped in a pocket, or on a belt or bum-bag.

The pump delivers a steady stream of hydrocortisone to match your individual needs. You can add more at times of stress or illness.

The London Clinic has a comprehensive range of the latest pumps. The multidisciplinary team will provide an individual training plan so that you are confident using the pump and adjusting your dosage when needed.

Trials show that this way of treating Addison’s disease or adrenal insufficiency is effective and can improve the quality of life for people living with the condition.

Addison’s disease is a rare condition that affects around 1 in 10,000 people. The adrenal glands stop working so that the body doesn’t have some of the essential steroid hormones it needs to function. For this reason, it is also known as primary adrenal insufficiency.

Adrenal insufficiency can also cause by the lack of descending hormone ACTH from the pituitary gland. ACTH stimulate adrenal gland to produce hydrocortisone.

If there is a lack of ACTH this could leads to the lack of cortisol production from the adrenal glands. In patients with chronic use of steroids, ACTH production is reduced and patients can also present with adrenal insufficiency

Adrenal glands are located near the kidneys. They produce aldosterone, which plays an essential role in the regulation of the body’s sodium levels, fluid balance and blood pressure, and DHEA, which has an impact on sex hormones.

They also release the crucial hormone cortisol, which has a vital physiological role. Cortisol provides the body with the energy it needs to respond to illness, infection, or attack and also acts as an inflammatory, easing irritation and pain.

The body can’t live and function without these essential hormones. However, regular steroid medication can replace the missing chemicals and maintain your health and wellbeing.

Hydrocortisone medication is usually given as a substitute for the missing cortisol. It is traditionally taken as a tablet two or three times a day. The drug replaces the missing hormone but doesn’t mimic the body’s inherent pattern of production.

The body naturally releases cortisol into the bloodstream in a rhythm. It’s linked to our sleep cycle, peaking in the early morning to wake us up and boost our energy, then gradually falling to a trough in the early hours of the morning, when we should be sleeping soundly.

Innovative medications can more closely copy these natural cycles or ‘circadian’ rhythms. Modified-release tablets are available to achieve more sustained levels; however, continuous subcutaneous hydrocortisone infusion or CSHI treatment is safe and effective.

It provides more physiological steroid hormone levels and also boosts your vitality.